Central venous cannulation: ultrasound techniques

Abstract 

Central venous cannulation is commonly undertaken by a range of specialties in diverse clinical settings. Central veins may be cannulated by the landmark, ultrasound-guided or open surgical cut-down techniques. Complications of central venous catheter (CVC) insertion are common and may lead to significant morbidity and very occasional mortality. Two-dimensional ultrasound-guided central venous catheter placement has been shown by randomized controlled trials to be superior to the landmark technique. It reduces both the number of needle passes required for successful placement and the incidence of complications. Constant needle-tip visualization is a challenge for the novice operator. The National Institute of Clinical Excellence (NICE) recommends that following appropriate training, clinicians should use ultrasound wherever practical in both elective and emergency internal jugular vein catheterization.

Keywords: central venous catheter, femoral, jugular, subclavian veins, ultrasound, venous cannulation